Intertester-Reliabilität des Skapula-Dyskinesis-Tests – Wie gut sind Physiotherapeuten in der Bewegungsbeobachtung?

Zusammenfassung

Bewegungsbeobachtung ist ein wesentlicher Bestandteil des physiotherapeutischen Untersuchungs- und Behandlungsprozesses. Eine ausreichende Intertester-Reliabilität stellt die Grundlage der Kommunikation zwischen Therapeuten sowie für einen nachvollziehbaren evidenzbasierten Untersuchungs- und Behandlungsprozess dar. Die vorliegende Studie untersucht die Intertester-Reliabilität der Observation der Skapulabewegungen während der Armhebung in der sagittalen und frontalen Ebene (Skapula-Dyskinesis-Test).

Das Maß der Intertester-Reliabilität der Beurteilung der Skapulabewegungen war „leicht” bis „mittelmäßig”. Wurde die Skapulabewegung nach 3 Kategorien beurteilt (keine Dyskinesis/leichte Dyskinesis/offensichtliche Dyskinesis), fiel die Übereinstimmung zwischen den Therapeuten deutlich geringer aus als bei Beurteilung nach einem Ja-/nein-System. Da die Beurteilung nach dem System mit 3 Kategorien eine unbefriedigende Zuverlässigkeit aufweist und keinen zusätzlichen klinischen Nutzen bringt, wird für den Skapula-Dyskinesis-Test bei der Beurteilung von Patienten mit Schulterproblemen die Verwendung von 2 Kategorien (Dyskinesis ja/Dyskinesis nein) empfohlen.

Abstract

Movement observation is a major component of physiotherapeutic assessment and treatment. An adequate inter-tester reliability is the basis for communication between physiotherapists as well as for evidence-based assessment and treatment procedures. This study assessed the inter-tester reliability of monitoring the scapula during arm lifting in the sagital and frontal plane (scapula dyskinesis test).

The inter-tester reliability of the scapula movement assessment was ”fair” to ”average”. When scapula movement was assessed according to a 3-level scale (no dyskinesis, subtle dyskinesis and obvious dyskinesis) the level of agreement between physiotherapists was considerably lower than in 2-level scale assessment (yes/no). As the assessment using the 3-level scale showed a dissatisfactory reliability and as this test does not yield additional clinical benefit for the scapula dyskinesis test for the assessment of patients with shoulder problems the use of the 2-level scale (yes/no) is recommended.

Intertester-Reliabilität - Kappa - PABAK - Skapula-Dyskinesis - Bewegungsbeobachtung

inter-tester reliability - kappa - PABAK - scapula dyskinesis - movement observation

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